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Laura M Wynter - One of the best experts on this subject based on the ideXlab platform.

  • stated preference survey for calculating values of time of road freight transport in france
    Transportation Research Record, 1995
    Co-Authors: Laura M Wynter
    Abstract:

    A survey based on a stated preference experiment aimed at obtaining information about road freight transport subsequently useful in evaluating freight transporters' critical values of time is presented. The Initial Hypothesis in designing the survey was that values of time may vary significantly across the population ; the experiment was thus designed so as to permit the evaluation of these critical values for each individual, as well as the identification of possible dependencies of the values on other trip attributes. The scope and methodology of the survey as well as an overview of the results are presented.

Kevin Mclaughlin - One of the best experts on this subject based on the ideXlab platform.

  • To think is good: querying an Initial Hypothesis reduces diagnostic error in medical students.
    Academic Medicine, 2010
    Co-Authors: Sylvain Coderre, Bruce Wright, Kevin Mclaughlin
    Abstract:

    PURPOSE Most diagnostic errors involve faulty diagnostic reasoning. Consequently, the authors assessed the effect of querying Initial hypotheses on diagnostic performance. METHOD In 2007, the authors randomly assigned 67 first-year medical students from the University of Calgary to two groups and asked them to diagnose eight common problems. The authors presented the same primary data to both groups and asked students for their Initial diagnosis. Then, after presenting secondary data that were either discordant or concordant with the primary data, they asked students for a final diagnosis. The authors noted changes in students' diagnoses and the accuracy of Initial and final diagnoses for discordant and concordant cases. RESULTS For concordant cases, students retained 84.2% of their Initial diagnoses and were equally likely to move toward a correct as incorrect final diagnosis (6.9% versus 8.9%, P = .3); no difference existed in the accuracy of Initial and final diagnoses: 85.9% versus 84.0% (P = .4). By contrast, for discordant cases, students retained only 23.3% of Initial diagnoses, change was almost invariably from incorrect to correct (76.3% versus 0.4%, P < .001), and final diagnoses were more accurate than Initial diagnoses: 80.7% versus 4.8% (P < .001). Overall, no difference existed in the accuracy of final diagnoses for concordant and discordant cases (P = .18). CONCLUSIONS These data suggest that querying an Initial diagnostic Hypothesis does not harm a correct diagnosis but instead allows students to rectify an incorrect diagnosis. Whether querying Initial diagnoses reduces diagnostic error in clinical practice remains unknown.

  • Initial diagnostic hypotheses bias analytic information processing in non visual domains
    Medical Education, 2008
    Co-Authors: Kevin Mclaughlin, Laura Heemskerk, Robert J Herman, Martha Ainslie, Remy M J P Rikers, Henk G Schmidt
    Abstract:

    CONTEXT Previous studies have shown that an Initial diagnostic Hypothesis biases automatic information processing. It is unclear if an Initial Hypothesis has a similar effect on analytic information processing. Our first objective was to study the effect of an Initial diagnostic Hypothesis on analytic processing. Our second objective was to assess the effect of clinical experience on analytic processing by evaluating the effect of clinical frequency and urgency of an alternative diagnosis on diagnosis selection. METHODS During a 12-minute objective structured clinical examination station, 19 subspecialty medical residents diagnosed the cause of 3 clinical presentations: dyspnoea; headache, and chest pain. Subjects were randomly allocated cases for which the suggested Initial Hypothesis was either correct or incorrect. For cases with an incorrect Initial Hypothesis, the alternative diagnoses varied in the frequency with which they are encountered in clinical practice, and their clinical urgency, relative to the Initial diagnostic Hypothesis. RESULTS All correct Initial hypotheses were retained, compared with 10.9% of incorrect hypotheses. All cases with a correct Initial Hypothesis were diagnosed correctly, compared with 65.2% of cases with an incorrect Hypothesis (risk ratio 1.5 [95% confidence interval 1.2-1.9], P = 0.02). Clinical frequency and urgency were not associated with alternative diagnosis selection. DISCUSSION Our results suggest that an Initial diagnostic Hypothesis biases analytic processing. The data used to reject an Initial Hypothesis appear to drive selection of an alternative Hypothesis. Further studies aimed at finding strategies for increasing the likelihood of generating a correct Initial Hypothesis or debiasing an Initial Hypothesis are needed.

  • Initial diagnostic hypotheses bias analytic information processing in non‐visual domains
    Medical Education, 2008
    Co-Authors: Kevin Mclaughlin, Laura Heemskerk, Robert J Herman, Martha Ainslie, Remy M J P Rikers, Henk G Schmidt
    Abstract:

    CONTEXT Previous studies have shown that an Initial diagnostic Hypothesis biases automatic information processing. It is unclear if an Initial Hypothesis has a similar effect on analytic information processing. Our first objective was to study the effect of an Initial diagnostic Hypothesis on analytic processing. Our second objective was to assess the effect of clinical experience on analytic processing by evaluating the effect of clinical frequency and urgency of an alternative diagnosis on diagnosis selection. METHODS During a 12-minute objective structured clinical examination station, 19 subspecialty medical residents diagnosed the cause of 3 clinical presentations: dyspnoea; headache, and chest pain. Subjects were randomly allocated cases for which the suggested Initial Hypothesis was either correct or incorrect. For cases with an incorrect Initial Hypothesis, the alternative diagnoses varied in the frequency with which they are encountered in clinical practice, and their clinical urgency, relative to the Initial diagnostic Hypothesis. RESULTS All correct Initial hypotheses were retained, compared with 10.9% of incorrect hypotheses. All cases with a correct Initial Hypothesis were diagnosed correctly, compared with 65.2% of cases with an incorrect Hypothesis (risk ratio 1.5 [95% confidence interval 1.2-1.9], P = 0.02). Clinical frequency and urgency were not associated with alternative diagnosis selection. DISCUSSION Our results suggest that an Initial diagnostic Hypothesis biases analytic processing. The data used to reject an Initial Hypothesis appear to drive selection of an alternative Hypothesis. Further studies aimed at finding strategies for increasing the likelihood of generating a correct Initial Hypothesis or debiasing an Initial Hypothesis are needed.

Filippo Ferrari - One of the best experts on this subject based on the ideXlab platform.

Henk G Schmidt - One of the best experts on this subject based on the ideXlab platform.

  • Initial diagnostic hypotheses bias analytic information processing in non visual domains
    Medical Education, 2008
    Co-Authors: Kevin Mclaughlin, Laura Heemskerk, Robert J Herman, Martha Ainslie, Remy M J P Rikers, Henk G Schmidt
    Abstract:

    CONTEXT Previous studies have shown that an Initial diagnostic Hypothesis biases automatic information processing. It is unclear if an Initial Hypothesis has a similar effect on analytic information processing. Our first objective was to study the effect of an Initial diagnostic Hypothesis on analytic processing. Our second objective was to assess the effect of clinical experience on analytic processing by evaluating the effect of clinical frequency and urgency of an alternative diagnosis on diagnosis selection. METHODS During a 12-minute objective structured clinical examination station, 19 subspecialty medical residents diagnosed the cause of 3 clinical presentations: dyspnoea; headache, and chest pain. Subjects were randomly allocated cases for which the suggested Initial Hypothesis was either correct or incorrect. For cases with an incorrect Initial Hypothesis, the alternative diagnoses varied in the frequency with which they are encountered in clinical practice, and their clinical urgency, relative to the Initial diagnostic Hypothesis. RESULTS All correct Initial hypotheses were retained, compared with 10.9% of incorrect hypotheses. All cases with a correct Initial Hypothesis were diagnosed correctly, compared with 65.2% of cases with an incorrect Hypothesis (risk ratio 1.5 [95% confidence interval 1.2-1.9], P = 0.02). Clinical frequency and urgency were not associated with alternative diagnosis selection. DISCUSSION Our results suggest that an Initial diagnostic Hypothesis biases analytic processing. The data used to reject an Initial Hypothesis appear to drive selection of an alternative Hypothesis. Further studies aimed at finding strategies for increasing the likelihood of generating a correct Initial Hypothesis or debiasing an Initial Hypothesis are needed.

  • Initial diagnostic hypotheses bias analytic information processing in non‐visual domains
    Medical Education, 2008
    Co-Authors: Kevin Mclaughlin, Laura Heemskerk, Robert J Herman, Martha Ainslie, Remy M J P Rikers, Henk G Schmidt
    Abstract:

    CONTEXT Previous studies have shown that an Initial diagnostic Hypothesis biases automatic information processing. It is unclear if an Initial Hypothesis has a similar effect on analytic information processing. Our first objective was to study the effect of an Initial diagnostic Hypothesis on analytic processing. Our second objective was to assess the effect of clinical experience on analytic processing by evaluating the effect of clinical frequency and urgency of an alternative diagnosis on diagnosis selection. METHODS During a 12-minute objective structured clinical examination station, 19 subspecialty medical residents diagnosed the cause of 3 clinical presentations: dyspnoea; headache, and chest pain. Subjects were randomly allocated cases for which the suggested Initial Hypothesis was either correct or incorrect. For cases with an incorrect Initial Hypothesis, the alternative diagnoses varied in the frequency with which they are encountered in clinical practice, and their clinical urgency, relative to the Initial diagnostic Hypothesis. RESULTS All correct Initial hypotheses were retained, compared with 10.9% of incorrect hypotheses. All cases with a correct Initial Hypothesis were diagnosed correctly, compared with 65.2% of cases with an incorrect Hypothesis (risk ratio 1.5 [95% confidence interval 1.2-1.9], P = 0.02). Clinical frequency and urgency were not associated with alternative diagnosis selection. DISCUSSION Our results suggest that an Initial diagnostic Hypothesis biases analytic processing. The data used to reject an Initial Hypothesis appear to drive selection of an alternative Hypothesis. Further studies aimed at finding strategies for increasing the likelihood of generating a correct Initial Hypothesis or debiasing an Initial Hypothesis are needed.

Edit Yerushalmi - One of the best experts on this subject based on the ideXlab platform.